Pregnant and due in August, Muireann Davis was meant to attend ante-natal groups for women who had previously suffered post-natal depression (PND), as she had after the birth of her first child. But the groups aren’t happening now. Covid-19 has seen to that.
“I’ll just have to plough on and stay indoors,” says the Limerick-based 33-year-old, whose son, Finn, is 22 months. When Muireann found she was pregnant this time, she wondered if she was in way over her head. “I’m fine now, but at the start I had a feeling of, ‘Oh, God! How am I going to cope? What was I thinking’?”
Immediately after Muireann had Finn, in July 2018, she “just wasn’t right”. She and her husband, Luke, had been trying for a baby for two years, but after a traumatic birth that involved a grade-three tear and significant blood loss, Muireann wasn’t feeling the way she’d assumed she would.
“I wasn’t feeling utter joy at bringing home my newborn baby. I had wanted him for so long and I couldn’t understand why I wasn’t feeling over the moon,” Muireann says.
Instead, she felt she wasn’t bonding with little Finn and she was scared to be on her own with him. “I was just so anxious. I was a wreck, crying all the time. I was good when Luke was there, but when he went back to work, I was so scared. I was worried about keeping Finn alive. What if something happened? Would I be able to manage? Of course, I’m well-able and I was then, too, but my mindset wasn’t the same,” Muireann says, recalling a day when her mother took the baby to give Muireann a chance to sleep. “But I just sat there, crying. I couldn’t switch off. My mind was in overdrive.”
Muireann had heard at ante-natal class about watching out for low mood on day three post-birth. “I felt every day was day three for me. My friends with babies said the blues are normal, but that my blues were going on an awful lot of the time,” she says.
Thanks to a concerned public health nurse (PHN), who “called over a lot and who could tell I wasn’t right”, and thanks to a free counselling service at the maternity hospital in Limerick to which her GP referred her — she saw a psychiatrist for a year — Muireann was diagnosed with PND and has emerged from its dark tunnel. “I’m much more aware now, so I’d know if things took a turn, and the psychiatrist says I can ring him if I need,” she says.
But — as it has for other expecting mothers — Covid-19 has brought worry and uncertainty. “You hear stories about husbands not let into the labour ward. I’m worried this will happen, when I come to have my baby. I dread that I’ll be on my own,” Muireann says.
Dr Krysia Lynch, chairperson of the Association for Improvements in the Maternity Services (AIMS), says potential Covid-19 restrictions for who is present during labour/birth are causing anxiety for expecting mothers. “Some hospitals are saying partners can come from the get-go — business as usual. At the other extreme, one unit in Ireland isn’t allowing partners in if the mother’s having a C-section, and for normal delivery partners will be phoned to come in 30 minutes before the birth. And you have everything in between on the spectrum,” Dr Lynch says.
Dr Lynch says that the best midwife can’t replace the woman’s partner, the person with whom she has planned this baby. “Her partner has been with her every step of the nine months. This is the person who’s going to be parenting this baby alongside her,” Dr Lynch says.
Aside from offering emotional support, partners are also women’s pain-coping mechanism. “In ante-natal class, the partner will have been taught massage techniques, how to keep the mum fed and hydrated, what positions might help her, how to encourage her with her breathing. And, suddenly, now, a woman going into this intense environment doesn’t have that,” Dr Lynch says.
If the partner isn’t there to advocate for her, to be the woman’s voice when she’s intensely in labour — about birth approaches they’d decided on pre-labour — there will be a rise in the rate of medical intervention, which won’t be good for mothers or for babies, Dr Lynch says.
But Covid-19 is impacting pregnant women in other ways. Concerned for their welfare, most expectant mothers are cocooning. “They’re not going to Tesco or walking in the park,” Dr Lynch says.
The hospital — for ante-natal visits — might be the only place they’re going. “They’re going into a hospital environment — where you’d feel anxious anyway — and they know there are germs.
“And their partner’s not with them, but waiting outside. Certainly, there’s an element of ante-natal anxiety existing at this Covid-19 time,” Dr Lynch says, adding that research shows a correlation between ante-natal anxiety and PND. “Mums anxious before labour are more likely to be anxious and depressed after the birth.”
And the net that would usually catch women afflicted with PND isn’t now as strong as it would have been. “Public health nurses screen every new mum they meet for potential perinatal mental health problems. They’d be indirectly asking: ‘How are you feeling in yourself? How are things going?’ They might knock on the mum’s door, say they were in the area and thought they’d pop in to see how she’s doing. These visits aren’t happening now. Some women are getting one PHN visit, some not even that,” Dr Lynch says.
Any woman who has concerns at the ante-natal stage, or if they’ve had a difficult birth experience, should contact firstname.lastname@example.org. “We will email or phone them back. They will be supported,” Dr Lynch says.
Mums urged to speak up about feeling down
To mark World Maternal Mental Health Day this Wednesday, the BabyDoc Club parenting community has launched #Askheragain. The campaign aims to raise awareness of just how common mental health issues are for women who are pregnant or in the first year of motherhood, also known as the perinatal period.
#Askheragain reminds partners/family members/friends/professionals to keep asking a pregnant or new mum how they’re feeling and coping during this uniquely vulnerable time.
In a survey of more than 1,800 mothers in BabyDoc Club’s digital parenting community, incidence of maternal mental health struggles surpassed the global average of one in five, with results somewhat elevated due to Covid-19:
Most common symptoms included: tearful (80%), low mood (79%), feeling overwhelmed/anxious (66%), negative body image (53%), believing they weren’t a good enough mother (51%), sleep difficulties (43%), feeling angry at self/partner/baby (41%). Fifty-five percent found it hard to ask for help, a further 33% blamed themselves for not coping, and 17% felt asking for help was a sign of weakness.
Laura Erskine, parenting expert with BabyDoc Club, says depression in the perinatal period mustn’t be underestimated. “It’s up to all of us to talk more about the challenges we face when coping with the emotional, physical, and hormonal changes that becoming a mother involves. From the time a woman becomes pregnant to her child’s first birthday, she is uniquely vulnerable.”